What are Microhealth Rewards?

The microhealth reward is a recycled innovation being reintroduced by way of the Affordable Care Act as a means of trying to motivate Americans to engage in healthy behaviors through extrinsic economic rewards. The way the law is currently written these monetary benefits can be marketed as either perceived rewards or penalties, but the basic premise of the expanded scope of these type of rewards equates to reductions in the cost of health insurance premiums if an individual is able to stay healthy (and in some cases prove it).

The way microhealth rewards will ultimately be adopted is still being played out. Monetary rewards for group challenges that fall under the realm of “participatory wellness programs” are nothing new, but there is empirical evidence to suggest that these types of rewards do not work (see Daniel Pink’s book Drive for a thorough investigation of this). Participatory wellness programs are usually available to any employee and can include incentives such as free or discounted fitness center memberships, free attendance to health education seminars or free health risk assessments.

“Health-contingent wellness programs” on the other hand offer microhealth rewards based on measures and outcomes. For example, you might receive a financial reward if you meet certain biometric requirements over time (ex. low cholesterol levels). Let’s say you move from an overweight BMI measure to a normal BMI measure within a given period of time, your employer will be able to offer you a financial incentive for your effort. You can also get rewards if you participate in certain activities and/or opt-in for services such as flu shots or regular visits with your doctor.

The expanded rewards that you can earn through a microhealth rewards program will now run the gamut, from gift cards for meeting activity goals to reductions in the total cost of your health insurance premiums for sharing biometric data with your employer (it is important to note here that all Americans are protected by HIPAA and that these are opt-in programs. An employer cannot force you to have to share medical information with them).

Microhealth rewards are another measure to inspire healthcare providers to become accountable care organizations (ACOs). ACOs do not use the traditional fee for service model that is common among more traditional health care organizations. The Affordable Care Act is encouraging health care programs to move towards incentives that reward people (as well as insurance providers and healthcare organizations) for preventive health measures over treatment. The spirit behind this innovation is that there is a significant body of evidence to suggest healthy people spend less on healthcare (see: Health and Wellness Research Study: Corporate and Worksite Wellness Programs). However, as I have stated earlier there is also a significant body of evidence to suggest that wiring people to be extrinsically motivated to stay healthy also has considerable drawbacks. Therefore, it will be important to stay on top of how these rewards perform and adjust so that their potential for benefit is optimized.

Microhealth rewards was heralded at this year’s Health 2.0 Conference as a major upcoming trend in health and wellness. Personally, I believe it will be one of the most significant innovations in health and wellness in 2014.